Hasjim Bima J, Ostowari Arsha, Gandawidjaja Monique, Mohammadi Mohsen D, Murphy Linda Suk-Ling, Whealon Matthew D, Vilchez Valery, Ichii Hirohito, Redfield Robert R, Eng Oliver S
Department of Surgery, University of California, Orange, CA, USA.
Industrial Engineering and Management Sciences, Northwestern University, Evanston, IL, USA.
Br J Cancer. 2025 Apr 5. doi: 10.1038/s41416-025-02994-7.
Kidney transplant (KT) patients have higher risks of developing de novo colorectal cancer (CRC) compared to the general population. However, there is still a knowledge gap in their clinical characteristics, as most single- or multi-center efforts are underpowered and lack generalizability.
PubMed, Web of Science, Cochrane CENTRAL, and Scopus databases were queried for studies published until July 22, 2024. Studies reporting the clinicopathologic characteristics and outcomes of de novo CRC among KT recipients were included.
There were 49 articles included involving 1855 KT patients who developed CRC. The mean time from transplantation to CRC diagnosis was 8·7 years (95%CI 7·2, 10·3 years; I = 98·3%). De novo CRC was most commonly located in the ascending colon (43·6%; 95%CI 29·5%, 58·9%; I = 55·3%), and 37·1% had advanced CRC at diagnosis (95%CI 22·3%, 54·8%; I = 64·1%). Although 68·8% underwent curative intent treatment (95%CI 45·4%, 85·4%; I = 65·4%), pooled 5-year survival rate was 31·8% (95%CI 10·5%, 65·1%; I = 82·5%).
De novo CRC was diagnosed in under 10 years after KT, and nearly 40% of patients already have advanced stage disease at diagnosis. The pooled rate of 5-year survival was 31.8%. However, there was wide heterogeneity between studies and further research is required. PROSPERO Registration: CRD42023415767.
与普通人群相比，肾移植（KT）患者患新发结直肠癌（CRC）的风险更高。然而，由于大多数单中心或多中心研究的样本量不足且缺乏普遍性，其临床特征方面仍存在知识空白。
检索了PubMed、科学网、Cochrane CENTRAL和Scopus数据库中截至2024年7月22日发表的研究。纳入报告KT受者中新发CRC的临床病理特征和结局的研究。
共纳入49篇文章，涉及1855例发生CRC的KT患者。从移植到CRC诊断的平均时间为8.7年（95%CI 7.2，10.3年；I=98.3%）。新发CRC最常见于升结肠（43.6%；95%CI 29.5%，58.9%；I=55.3%），37.1%在诊断时患有晚期CRC（95%CI 22.3%，54.8%；I=64.1%）。尽管68.8%接受了根治性治疗（95%CI 45.4%，85.4%；I=65.4%），但汇总的5年生存率为31.8%（95%CI 10.5%，65.1%；I=82.5%）。
KT后不到10年诊断出新发CRC，近40%的患者在诊断时已处于晚期疾病阶段。汇总的5年生存率为31.8%。然而，研究之间存在广泛的异质性，需要进一步研究。PROSPERO注册编号：CRD42023415767。
